High-rise syndrome in cats

High-rise syndrome was diagnosed in 132 cats over a 5-month period. The mean age of the cats was 2.7 years. Ninety percent of the cats had some form of thoracic trauma. Of these, 68% had pulmonary contusions and 63% had pneumothorax. Abnormal respiratory patterns were evident clinically in 55%. Other common clinical findings included facial trauma (57%), limb fractures (39%), shock (24%), traumatic luxations (18%), hard palate fractures (17%), hypothermia (17%), and dental fractures (17%). Emergency (life-sustaining) treatment, primarily because of thoracic trauma and shock, was required in 37% of the cats. Nonemergency treatment was required in an additional 30%. The remaining 30% were observed, but did not require treatment. Ninety percent of the treated cats survived.     

Spontaneous femoral capital physeal fractures in adult cats: 26 cases (1996-2001)

OBJECTIVE: To determine clinical, radiographic, and histologic abnormalities in adult cats > 1 year old with spontaneous (ie, nontraumatic) femoral capital physeal fractures. DESIGN: Retrospective study. ANIMALS: 26 cats. PROCEDURE: Medical records of cats > 1 year old with femoral capital physeal fractures and no history of trauma were examined. RESULTS: Mean +/- SD age of the cats was 22.5 +/- 6.5 months. Twenty-five cats were neutered males. Mean weight of the cats was significantly greater than mean weight of a group of age- and sex-matched control cats. Of 16 cats for which age at the time of neutering was known, 14 had been neutered before 6 months of age. Nine cats had bilateral fractures. Severity of femoral neck osteolysis and sclerosis increased with increased duration of clinical signs. The contralateral femoral capital physis, distal femoral physes, and proximal tibial physes were radiographically open in 13 of 18,19 of 24, and 24 of 24 cats, respectively. Histologically, the epiphysis contained normal articular cartilage and bone, but attached growth plate cartilage lacked the normal columnar arrangement of chondrocytes. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that adult cats with spontaneous femoral capital physeal fractures were most likely to be heavier, neutered males with delayed physeal closure.     

Femoral neck fractures and capital epiphyseal separations in cats

In a retrospective study, 47 fractures of the femoral neck and 17 capital epiphyseal separations were recorded in a total of 62 animals over a 12-year period. It was found that cats sustain femoral neck fractures more often than capital epiphyseal separations. Until cats are six months old the vast majority of lesions in the proximal femur are fractures of the neck. Between the ages of six and 12 months both lesions are equally represented. After 12 months of age no capital epiphyseal separations occur and the incidence of femoral neck fractures diminishes appreciably. If left untreated, an acceptable clinical result can be obtained in both femoral neck fractures and capital epiphyseal separations, although the best functional result is achieved in femoral neck fractures. In the present study, spontaneous healing was seen only in femoral neck fractures in cats younger than three months. All cats with capital epiphyseal separations developed hypertrophic pseudoarthrosis.     

Pancreatic rupture in four cats with high-rise syndrome

Pancreatic trauma and rupture are rare after feline high-rise syndrome; however, should it happen, pancreatic enzymes will leak into the abdominal cavity and may cause pancreatic autodigestion and fatty tissue saponification. If not diagnosed and treated, it can ultimately lead to multiorgan failure and death. In this case series, 700 records of high-rise syndrome cats that presented between April 2001 and May 2006 were analysed, and four cats with pancreatic rupture were identified. Clinical signs, diagnosis using ultrasonography and lipase activity in blood and abdominal effusion, and treatment modalities are reported. Three cats underwent surgical abdominal exploration, one cat was euthanased. Rupture of the left pancreatic limb was confirmed in all cases. Two of the operated cats survived to date. High-rise syndrome can lead to abdominal trauma, including pancreatic rupture. A prompt diagnosis and surgical treatment should be considered.     

Bilateral calcaneal stress fractures in two cats

Two cats that developed bilateral calcaneal stress fractures are reported. One cat developed lameness associated with incomplete fractures at the base of both calcanei, both of which progressed to acute, complete fractures 2 months later. The second cat presented with acute complete calcaneal fracture, with evidence of remodelling of the contralateral calcaneus, which subsequently fractured two years later. The calcaneal fractures were successfully stabilised with lateral bone plates in each case. Stress fractures were suspected because of the bilateral nature, the simple and similar configuration, the consistent location of the fractures, the absence of other signs of trauma in both cases and the suspected insidious onset of the lameness. The feline calcaneus is susceptible to stress fracture, and cats presenting with calcaneal fractures without evidence of trauma should be evaluated for concurrent skeletal pathology.     

Dowel pinning for feline metacarpal and metatarsal fractures.

The goal of this retrospective study was to describe dowel pinning, and to compare the results of osteosynthesis and external coaptation of metacarpal and metatarsal fractures in cats. Evaluation of the medical records of 351 cats yielded 63 cats treated with dowel pinning, 35 cats treated with external coaptation and 14 cats treated with both methods within the same limb. All of the cats had been re-evaluated at an average of 2.8 years (six months - 15 years) postoperatively. Dowel pinning was superior to external coaptation when all fractured bones of a limb could be pinned. When internal fixation of multiple fractures was not feasible in all fractured bones due to comminution or fragments that were too short to pin, the outcome was not significantly different from cases treated with external coaptation alone. Malunion was seen in 16% of fractured bones in cats treated with external coaptation and occurred secondary to implant bending in 3% of fractured bones treated with dowel pinning. The latter refers to one operated cat, which had four metacarpal fractures in the same limb. Radiographs taken at re-evaluation showed implant migration within the medullary canal in two cats, although neither showed any signs of non-union or lameness. Non-union was seen in one operated cat, in which the fracture (MC IV) could not be completely reduced with a K-wire. Osteomyelitis did not occur. Dowel pinning is an easy, inexpensive and effective technique for repair of metacarpal and metatarsal fractures in cats.     

A survey of bone fractures in the cat

A survey of 108 bone fractures in the cat was made over a 1 year period in a city practice in south west England. Seventy-three per cent involved the pelvic limb. The three bones most commonly affected were femur (38%), pelvis/sacrum (22%) and mandible (16%). Forty-five cases were the result of road accidents and 75% of cats were 2 years old or less.
Treatment of femoral shaft fractures by intramedullary pinning gave good results. The majority of proximal epiphyseal separations and femoral neck fractures responded well to conservative treatment. 'Cage rest' was used successfully to treat severely comminuted femoral shaft fractures. All cases of pelvic fracture were treated conservatively (up to 3 weeks 'cage rest'). Separation of the mandibular symphysis and fracture of the horizontal ramus healed readily. Repair of tibial (10%) and humeral (5%) fractures was without complications.     

Mandibular Fractures in the Cat A Retrospective Study

A retrospective study was made of 75 mandibular fractures in 62 cats. Mandibular fractures comprised 14.5% of all fractures seen in 517 cats. Automobile trauma was the cause of injury in more than 50% of the cases. The mean age of patients was 29.5 months. Symphyseal fractures were most common (73.3%), followed by fractures of the body (16%), condyle (6.7%), and coronoid process (4%). Sixty-seven percent of the fractures were stabilized. Cerclage and interfragmentary wiring were the most common forms of fixation. Antibiotics were administered to 73.6% of the patients. Complications were reported in 24.5% of the cats. Malocclusion and soft tissue infections were the most frequent complications. Complications developed more commonly in cats with multiple or open fractures. Clinical union occurred by an average of 6 weeks (range, 3-12 weeks) for symphyseal fractures, 10 weeks (range, 8-16 weeks) for body fractures, 6 weeks for coronoid fractures, and 6 weeks (range, 4-8 weeks) for condylar fractures.     

Thoracic wall and pulmonary trauma in dogs sustaining fractures as a result of motor vehicle accidents

The records of 267 dogs seen at the University of Minnesota Veterinary Teaching Hospital for fractures resulting from motor vehicle accidents were examined to determine the prevalence and types of thoracic wall and pulmonary trauma associated with such cases. Results were analyzed for type and prevalence of thoracic wall and pulmonary injury, and for the prevalence of such injury in dogs with and without extrathoracic injury, in dogs with fractures of single vs multiple bones, in dogs with single fractures of specific bones, in dogs with fractures in the cranial vs the caudal one half of the body, and in dogs with fractures ipsilateral vs contralateral to thoracic injury. The overall prevalence of thoracic wall and pulmonary trauma was 38.9%; pulmonary contusions, pneumothorax, and fractured ribs were the most common injuries. More than 1 type of thoracic wall or pulmonary injury was diagnosed in 57.7% of the cases. Of the dogs with thoracic injury, 24% also had extrathoracic injuries; 16.5% of dogs without thoracic injury had extrathoracic injuries, not including fractures. Of the dogs with fractures of 1 bone, 36.3% had thoracic injuries. Of the dogs with fractures of more than 1 bone, 42.3% had thoracic injuries. The prevalence of thoracic wall and pulmonary trauma was significantly associated with the site of the fracture (cranial vs caudal and ipsilateral vs contralateral); significant association with the specific bone fractured was also seen for some fractures.     

Repair of diaphyseal femoral fractures in cats using interlocking intramedullary nails: 12 cases (1996-2000).

OBJECTIVE: To determine the outcome of femoral fractures repaired with 4.0- and 4.7-mm interlocking intramedullary nails in cats. DESIGN: Retrospective study. ANIMALS: 12 cats with diaphyseal femoral fractures. PROCEDURE: Records of all cats in which the 4.0- and 4.7-mm interlocking nail system was used for repair of diaphyseal femoral fractures at the Animal Medical Center and Florida Veterinary Specialists between 1996 and 2000 were reviewed. Information included signalment, type of fracture, size of the implant, details of the surgery, intra- and postoperative complications, fracture healing, and clinical outcome. RESULTS: Femoral fractures in 12 cats were repaired. Eleven of the fractures were comminuted, with 2 of these being open. Clinical outcome was excellent in 7 cats, good in 3, and fair in 1. One resulted in a nonunion. Complications included screw breakage (1 cat) and fracture distal to the nail (1). Fracture distal to the nail occurred from a second trauma. CONCLUSION AND CLINICAL RELEVANCE: Use of the interlocking nail has been limited in cats because of the small diameter of the medullary canal. Use of the 4.0-mm nail will allow for greater application of this implant in small patients. Results of this study indicate that the 4.0- and 4.7-mm interlocking nails can be used to repair simple or comminuted diaphyseal femoral fractures in cats.     

Retrospective study of 38 cases of femur fractures in horses less than one year of age.

Medical records of 38 horses less than 1 year of age and diagnosed as having a fracture of the femoral diaphysis, metaphysis or distal physis were evaluated. Twenty-six foals had fractures of the femoral diaphysis or metaphysis with the most common fracture configuration being comminuted. Twelve foals had distal physeal fractures with the most common fracture configuration being a Salter-Harris type II. Twenty-one foals with fractures of the capital femoral physis, neck or greater trochanter during the same time period were excluded from this study. Surgical repair was attempted in 16 diaphyseal and 2 distal physeal fractures. Most of the diaphyseal fractures were repaired by placing plates on the lateral and cranial surfaces of the bone. Dynamic condylar screw plates or angle blade plates were used for increased bone purchase in 4 foals with short distal fragments. Five foals with distal physeal fractures were treated; 2 were surgically treated by placing an angle blade plate on the lateral cortex, and 3 foals with minimally displaced distal physeal fractures were managed with stall confinement. Eight of the 16 surgically repaired diaphyseal fractures healed. Fracture location and configuration was not a determinant of outcome, but the mean age of foals with successfully repaired diaphyseal fractures was 2 months compared with 4 months for the unsuccessful cases, indicating that the age and size of the foal was important. Long-term follow up revealed that 6 of the 8 successfully repaired diaphyseal fractures had no residual effects of the fracture observed during performance of the horse for its intended use. Only 1 of the 2 surgically repaired distal physeal fractures healed, but this horse was eventually killed because of unthriftiness related to a malabsorption syndrome. Some form of complication developed in 13 of the 18 surgically repaired fractures. Infection was the primary cause of failure. The greatest determinant associated with infection was the inability to control post-surgical seroma formation.     

Primary ocular sarcomas in the cat

Primary ocular sarcomas were diagnosed following enucleation (12) or necropsy (one) in 13 cats over an eight year period. Twelve of the 13 cats were males; ages of affected animals were seven to 15 years, with a mean of 12. Five of the cats had a history of previous trauma and six others had a history of chronic uveitis. Morphologically the neoplasm was comprised of undifferentiated spindle cells and appeared to arise in the anterior uvea. The cancer was quite aggressive, with extension into adjacent tissues and/or distant metastases commonly encountered. Seven of 12 cats experienced confirmed tumour related deaths within months following enucleation and one was humanely destroyed at the time of original presentation.     

Retrograde placement of a novel 3.5 mm titanium interlocking nail for supracondylar and diaphyseal femoral fractures in cats.

Twenty-four simple or comminuted supracondylar and diaphyseal femoral fractures in cats, which had been treated by retrograde insertion of a new 3.5 mm titanium interlocking nail (IN) from the intercondylar notch, were evaluated between June 2000 and October 2004 at the Ecole Nationale Vétérinaire d'Alfort. Patient data (species, breed, weight, and age), fracture characteristics, details of the surgery, post-operative complications and radiographic follow-up were recorded. The mean body weight was 3.75 kg and the cats ranged in age between four and 66 months (mean 29 months). The IN had a diameter of 3.5 mm and a length of 100, 109 or 119 mm, and were all fixed in a static position (two screws in seven cats, three screws in 10 cats and four screws in seven cats). Cerclage wires were used in seven cats and an autogenous bone graft was used in two cats. Screw or nail breakage were not recorded. Nineteen fractures healed without any complications, three cats died during the post-operative period from unknown causes, and two cats showed delayed bone healing. Twenty cats were considered to have an excellent limb function at one month. One cat with a sciatic injury was non-weight bearing for several months. Radiographic signs of degenerative joint disease of the stifle joint were not observed except in the cat with the sciatic nerve injury. The results of this study suggest that this new 3.5 mm titanium IN can be introduced from the intercondylar notch and be used in static fixation mode to stabilize supracondylar and diaphyseal femoral fractures in cats.     

Surgical reduction and stabilization for repair of femoral capital physeal fractures in cats: 13 cases (1998-2002)

OBJECTIVE: To evaluate anatomic reduction and surgical stabilization of femoral capital physeal fractures in cats. DESIGN: Retrospective study. ANIMALS: 13 cats. PROCEDURE: Medical records of cats with unilateral or bilateral femoral capital physeal fractures evaluated from 1998 to 2002 were reviewed. Age and weight of cats at the time of surgery; breed; sex; concurrent injuries; severity of lameness before and 1, 2, 4, 6, and 8 weeks after surgery; the amount of fracture reduction achieved and number of Kirschner wires (K-wires) used; degree of degenerative joint disease of the hip joint and lysis of the femoral neck and head observed after surgery; whether K-wires were removed after surgery; and complications after surgery were evaluated. RESULTS: Thirteen cats with 16 capital physeal fractures were identified. There was significant improvement in the severity of clinical lameness in all cats from weeks 1 through 4 after surgery. There was no correlation between the scores of the individuals who evaluated radiographs for fracture reduction and placement of K-wires. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that surgical stabilization and repair of femoral capital physeal fractures facilitate a short recovery period and a good prognosis for return to normal function in cats.     

Clinical features therapy and epidemiology of tiger snake bite in dogs and cats

SUMMARY Snake bite was diagnosed in 125 dogs and 115 cats over 10 years. Young sporting dogs and young cats were mainly affected. More dogs (48%) were seen in contact with tiger snakes than cats (7%). One hundred and four (84%) dogs and 89 (76%) cats were bitten in the warmer months of the year (October to March). As the incidence rose in September /October, dogs were bitten on days when the temperature was near 20°C or over. The commonest presenting signs were dilated pupils and absences of pupillary light reflex. Dyspnoea, hypothermia, hindleg ataxia and glycosuria were common features in cats. Vomiting, tachypnoea, hyperthermia and complete flaccid paralysis were often seen In dogs. The overall recovery rate after administering antivenene was 90% for cats and 83% for dogs. Death from anaphylaxis as a result of giving antivenene occurred in 3 cats and one dog. Dogs treated soon after being bitten recovered more rapidly. There was no correlation between the bite-to-treatment period and the treatment-to-recovery period for cats.     

Fractured capital femoral epiphysis in twin ewes

Capital femoral physeal fractures occurred simultaneously in twin 2-year-old Shropshire ewes. The fractures resulted in gradual, progressive lameness and recumbency. There was no history of trauma and no other ewes in the flock were affected. The fractures occurred at an age when the capital physis should have been closed. Clinical and postmortem examination of the ewes and evaluation of the ration did not reveal predisposing factors for the condition. A familial tendency for fractured capital femoral epiphysis is well documented in human beings, but there is no known familial tendency in sheep.     

Fractures secondary to nutritional bone disease in dogs: a review of 38 cases

The pattern of bone fractures secondary to nutritional bone disease in 38 dogs was analysed using a radiographic survey. The majority of fractures were either caused by a fall (28.95%) or showed no history of direct trauma (31.58%). Mongrels were more commonly affected by pathological fractures, followed by Dobermanns and German Shepherds. Significantly more (P < 0.05) fractures were found in dogs aged less than 6 months (64.71%). The incidence of such fractures was significantly higher in males than in females (M:F = 2.70:1.00). General radiological signs included a generalized decrease in cortical density, thinning of cortices and widening of metaphyses/epiphyses in most of the animals. Fractures were found significantly more frequently (P < 0.01) in the femur (81.58%) than in any other bone. Of the different types of fracture, complete oblique and incomplete fractures were most common.     

Orthopaedic disease affecting the pelvic region of the cat

Clinical cases of pelvic disease in the cat were surveyed over a 5 year period and were classified into proximal femoral epiphyseal separation and femoral neck fracture (19-6%), anterodorsal hip luxation (19-6%), pelvic fracture (34%), sacroiliac separation (16%), sacral and coccygeal fracture separation (7-2%) and neoplasia (3-1%).
Treatment of proximal femoral epiphyseal separation and femoral neck fracture by excision arthroplasty gave a more rapid return to soundness compared with conservative treatment. The majority of hip luxations responded well to external reduction and restricted exercise for 2-4 days. All cases of pelvic fract. ure were treated conservatively (2-14 days of 'cage-rest') and showed marked improvement within 2 weeks. Radiographic and clinical assessment of these revealed that the fractured bones eventually stabilized in their displaced positions. Sacral and coccygeal fracture separations required careful evaluation for bladder function and some cases needed tail amputation. Certain complications associated with conservative treatment of pelvic injuries in cats have been considered although in no case did these prove a serious clinical problem. Two cases of giant cell sarcoma and one of spindle cell sarcoma, of periosteal origin, were included in the survey.     

Orofacial manifestations of high-rise syndrome in cats: a retrospective study of 84 cases

Medical records of cats with high-rise trauma were reviewed to document the prevalence and clinical manifestations of orofacial injury. Cats were presented over a 10-year period from January 2000 to December 2009. Signalment, weight, number of stories fallen, and survival data were recorded in 84 cats and physical examination findings were obtained from 83 cats. Fourteen of these cats were examined by veterinarians of the Dentistry and Oral Surgery Service. Mean age was 37-months. Mean distance fallen was 2.65 stories, and in the majority of cases the substrate the cat fell on was not recorded Overall, survival was 94.0% when including euthanasia as a cause of death and 98.8% when excluding euthanized patients. Orofacial findings included bilateral epistaxis, hard palate fracture +/- tear of palatal soft tissue, palatal soft tissue bruising, mandibular fracture, mandibular symphyseal separation, tongue injury, facial soft tissue injury, dental trauma, and other oral soft tissue injury. Sixty-six percent of cats suffered some degree of orofacial injury. The population was analyzed for the prevalence of each type of injury. An oronasal fistula was seen in one cat as a complication of an untreated hard palate fracture. Possible etiology of the injuries and treatment options are discussed.     

MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient

Complete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty‐nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty‐eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3‐32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.